chapter 24
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| the CNS into what two parts | brain and the spinal cord
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| What is the outer portion of the gray matter of the brain called | cortex
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| Name the parts of the brain | crebrum, cerebellum, and brainstem
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| What part of the brain continous with the spinal cord | brainstem
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| What does the brainstem consist of | midbrain, pons, and medulla oblongata
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| What is the largest part of the brain | cerebrum
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| What is another name for the cerebrum | forebrain
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| What is the forebrain is divided | into lobes and lobules
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| What is the stemlike portion that connects the cerebrum and the pons and cerebellum | midbrain
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| What makes up the hindbrain | cerebellum, pons, and medulla oblongata
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| What is the deep cleft that seperates the cerebrum in right and left hemispheres | longitudinal sulcus
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| What is the name of the fluid filled cavity that is contained in each of the cerebral hemisphere | lateral ventricle
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| At the diencephalon, or second portion of the brain, the thalami surrounds ________ ________ | third ventricle
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| What gland is the mastery endocrine gland of the body and is inferior to the diencephalon | pituitary gland
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| Where do the pituitary gland reside | in the hypophyseal of the sella turcica
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| What forms the upper part of the hindbrain, and is the commissure or bridge between the cerebrum, cerebellum, and medulla oblongata | pons
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| What extends between the pons and the spinal cord, and forms the lower portion of the hindbrain | medulla oblongata
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| What extends from the brain where it connects to the medulla oblongata at the level of the foramen magnum | spinal cord
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| To what level do the spinal cord extends | to the level of the space between the first and second lumbar vertebrea
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| Where do the spinal cord ends | in the pointed extremity called the conus medullaris
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| How long is the adult spinal cord | 18 to 20 inches long
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| The spinal cord is connecte to how many pairs of nerves | 31
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| What are the nerves transmitted through | intervertebral and sacral foramina
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| The nerves resemble _______ and is referred to the _________ | horse's tail, cauda equina
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| What does the nerves and spinal cord work together to perform | transmit and receive sensory, motor, and reflex messages to and from the brain
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| What is the inner sheath of the spinal cord called | pia mater
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| What is the latin name for the inner sheath of the spinalcord | tender mother
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| What is the central sheath of the spinal cord called | arachnoid
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| What does the ventricles of the brain and the subarachnoid contain | CSF Cerebrospinal fluid
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| What is the function of the cerebrospinal fluid | surrounds and cushions the structures of the CNS
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| What is the outer most sheath of the spinal cord called | dura mater
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| what is the latin name of the outer most sheath of the spinal cord called | hard mother
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| What does the outer sheath of the spinal cord formed | the strong fibrous covering of the brain and spinal cord
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| How far do the dura mata extends | below the spinal cord ( to the second level of the sacral segment)
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| What is the function of the dura mater | to enclose the spinal nerves
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| How are the spinal nerves prolonged | inferiorly from the cord to their respective exits
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| What is the lower portion of the dura mater called | the dura sac
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| What is enclosed by the dura sac | the cauda equina
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| What are the two upper chambers of the brain called | right and left lateral ventricles
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| What is the central portion of the lateral ventricle called | the body
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| How is the body of the wo lateral ventricles prolonged | anteriorly, posteriorly, and inferiorly into hornlike portions
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| What connects each lateral ventricle to the third ventriclee | by a channel called the interventricular foramen
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| What is the slitlike cavity of the brain witha quadrilateralshape | third ventricle
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| What is diamond shaped and is located in the area of the hindbrain | fourth ventricle
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| where is the fourth ventricle located | anterior to the cerebellum and posterior to the pons
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| Where do the cerebrospinal fluid exit | fourth ventricle
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| What can be employed to demonstrate bony anatomy | radiographs of the cerebral and visceral cranium and rhe vertebral column
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| Why are radiograohs obtained | to detect bony injury, sublaxation, or dislocation of the vertebral column and determine the extent and stability of the bony injury
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| What should be obtained before myelogtaphy | radiographs of the spine
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| Why is a noncontrast spinal image used | because the contrast agents used in myelography may obscure some abnomalities
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| what complements the myelographic examination and often provide additional information | noncontrast spinal images
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| What is myelography | radiography examination of the CNS structures situated within the vertebral canal
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| How is the myelography performed | by introducing a nonionic, water soluable contrast medium into the subarachnoid space by spinal puncture
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| Where does the spinal puncture of the myelography take place | from L2-L3 or L3-L4 (2). cisterna magnum btween C1 and the occipital bone
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| What are the term for the injection into the subarachnoid space | intrathecal injection
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| What basis are the myelographs performed | outpatient basis
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| What is the recovering time for patient after the procedure and they are allowed to go home | 4 to 8 hrs
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| What has largely replaced myelographs | MRI
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| What do myelography demonstrates | spinal cord compression caused by a herniated disk, bone fragments, tumors and spinal cord swelling resulting from traumatic injury
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| What is useful in identifying narrowing of the subarachnoid space by evaluating the dynamic flow of the CSF | Myelography
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| What type of contrast was introduced in 1942 | a non water soluable, iodinated este
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| True or False: In 1942 the non water soluable iodinated ester could be obsorbed by the body | False
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| What provide good visualization of nerve roots and good enhancement for the follow-up CT of the spine | non water soluable contrast media
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| What water soluable agents have commonly been used for myelography | iopamidol and iohexol
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| What should technologist who perform myelography be educated in | the use of contrast media
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| What can cause severe and fatal neurtoxic reactions | intrathecal administration of ionic contrast media
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| Where are departments encouraged to store contrast media for myelographs | seperately from other agents
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| How many times should contrast vials be checked | 3 times
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| True or False: The contrast vial should be checked with the physician proforming the examination | True
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| What should the appropriate completed documentation contain | lot number and expiration date of contrast media
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| What is the responsibility of the radiographer before the patient arrive | prepare the examination room
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| What should be cleaned because the procedure involves aseptic techniques | table, and overhead equipment
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| The ________ should be attached to the table and the ______________ should be placed and ready for adjustment to the patient height | footboard, padded shoulder supports
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| What should be locked so it cannot accidently come in contact with the spinal needle, sterile field, or both | image intensifier
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| Where is the spinal puncture and contrast medium injection performed | radiology department
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| Under what observationis the contrast injection made | fluoroscopic
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| What size is the spinal guage needle | 2o to 22 guage needle
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| Where is the 20 to 22 guage needle for the spinal puncture and contrast medium injected | in the subarachnoid space
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| What must be verified first before the contrast medium injection is administered | the subarachnoid space
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| What must the radiographer do before the examination begins | explain the details of the myelograph
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| What should the patient be informed about the radijograph table | the the angulation of the table will be repeatedly changed and acutely changed
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| What images are often requested after the examination procedure | scout images including a cross table lateral lumbar spine prone
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| For the spinal puncture how do the physician perfer the patient to be positioned | placed on the table in the prone position
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| What position of the patient do the physicians perfer to widen the interspinous spaces for easier introduction of the needle | the lateral position with the spine flexed
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| what does the physician usually withdraws for laboratory analysis | CSF
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| How much nonionic contrast medium does the physician injects after withdrawing CSF | 9 to 12 mL
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| What allows gravity to direct the contrst to the area of interest | the angulationof the table
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| What is taken throughout the procedure | spot images
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| For the conus projection in the AP position where is the central ray centered | to T12-L1
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| True or False: The conus projection in the AP position used a cassette | True
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| Why is the position of the patient's head important in a cervical myelograph | to prevent the medium from passing into the cerebral ventricles
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| How is the head positioned for the myelograph of the cervical | acute extension of the head
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| Where sre the patients monitored after the procedure | in the recovery area
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| How many degrees are the patient's head and shoulders elevated during recovery | 30 to 45 degrees
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| What precautions are taken after the myelograph procedure | bedrest, plenty of fluids, puncture site examined before patient is released from the recovery area
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| What is an noninvasive imaging technique introduced in 1970's | CT
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| What allows for the changes of density and contrast of an image | digital image processing techniques in CT
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| How is the CT examination of the brain commonly performed | in an axial orientation with the gantry placed in an an angle of 20 to 25 degrees
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| What is the thickness of the slice often used in the CT imaging | 8 to 10mm
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| What is required before and after IV injection of a nonionic water soluable contrast agent | CT scans of the brain
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| what are the two nonionic water soluable contrast agent | preinfusion and postinfusion
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| What are common indications of CT of the brain without an IV infusion of contrast material include______ | assessment of dementia, craniocerebral trauma, hydrocephalus and acute infarcts
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| What is particularly useful for demonstrating the size, location, and configuration of mass lesions, hematomas, and aneurysums | CT of the brain
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| What examination that can clearly demonstrate the size,number, and location of fracture fragments in the cervical, thoracic and lumbar spine | CT of the spine
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| Preoperative what is used to assess the outcome of the surgical procedure | CT
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| What involves the CT examination of the intrathecal injection of thewater soluable contrast agent | CTM (computed tomography of myelography)
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| what are extremely useful in patients withcomprehensive injuries or in determining dural tears resulting in extravasation of the CSF | CTM
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| In the 1980's what became the modality of choice for evaluating many anomalies of the brain and spinal cord | MRI
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| What is an noninvasive procedures that provides excellent anatomic detail of the brain, spinal cord, intervertebral disk and CSF | MRI
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| What procedures do not require intrathecal injection of a contrast agent | MRI of the spinal cord and subarachnoid space
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| Which modality is basically blind to bone, unlike other conventional radiographic imaging modalities | MRI
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| What allows sirect visualization of the cord, nerve roots, and surrounding CSF | MRI
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| What paramagnetic IV contrast agents are used to enhance tumor visualization | gadolinium
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| What are the contridictions to the MRI primarily related to | a magnetic field
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| MRI should not be used on patients with what devices | pacemakers, ferromagnetic aneurysm clips, or metallic spinal fusion rods
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| How is angiography used | to assess vascular supply to tumors, demonstrate the relationship between a mass lesion and intracebral vessels, or illustrate anomalies of a vessel, aneurysm, or a vascular occlusion
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| What is the minimal focal spot size of an angiographic x-ray tube | 1.3 mm
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| What is the minimal magnification focal size of an angiographic x-ray tube | 0.3mm
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| What happens after the catheter is placed in the appropriate position | a nonionic water soluble contrast agent is injected into the vessels and rapid sequence images are obtained for evaluation
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| What involves the placement of various coils, medications, filters, stents and other devices to treat a particular problem or provide therapy | Interventional radiology
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| What are some therapeutic devices used in the cardiovascular ad interventional areas | filters, stents, shunts
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| What are tems used to denote radiologic examination of individual intervertebral disks | Diskography and nucleography
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| what is used in the investiation of internal disk lesion, such as rupture of he nucleus pulposus | diskography
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| What have largely replaced diskography | MRI, CTM
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| What procedures used to treat spinal compression fractures and other pathologies of the vertebral bodies that do not respond to conserative treatment | Vertebralplasty and kyphoplasty
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| What is defined as the injection of a radiopaque bone cement into a painful compression fracture under fluoroscopic guidance | Percutaneous vertebroplasty
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| What is advanced into the fractured vertebral body under fluoroscopy in the percutaneous vertebralplasty | a specialized trocar needle
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| What stabilizes fracture fragments and leads to reduction in pain | cement
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| What postprocedural projections of the spine is included to confirm cement position | the AP and lateral projections
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| How do the kyphoplsty differ from the percutaneous kyphoplasty | in that balloon catheter is used to expand the compressed vertebral body before the injection of the bone cement
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| What can help restore the spine to a more normal curature and reduce hunchback deformities | kyphoplasty
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| What is the success rate of the use of kyphoplasty and vertebroplasty | 80 to 90 percent
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| What is the complication of the vertebralplasty andkyphoplasty | leakage of cement before it hardens
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| What complications have been reported in the use of vertebroplasty and kyphoplasty | embolism and death
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| What should discusse with the patient about the vertebroplasty and kyphoplasty procedures | risks, benefits, and alternatives
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| What are recommended for technologist that are performing these procedures of ertbroplasty and kypoplasty | educated in these procedures and make sure that an informed consent has been documented
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| Radiographic examination of the of the blood vessels after the injection of contrast medium | angiograhy
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| A thin delicate membrane surrounding the brain and spinal cord | arachnoid
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| The portionof the central nervous system contained within the cranium | brain
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| A collection of nerves licated iin the spinal canal inferior to the spinal ccord | cauda equina
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| The part of the brain located in he posterior cranial fossa behind the brainstem | cerebellum
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| The fluid that flows through and protect the ventricles, subarachnoid space, brain, and spinal cord | cerebrospinal fluid
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| The largest uppermost portion of the brain | crebrum
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| The most inferior portion of the spinal cord | conus medullaris
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| The outer most surface of the brain | cortex
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| The tough outer layer of the meninges, which lines the cranial cavity and spinal cord | dura mater
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| Outside or above the dura mater | epidural space
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| An IV ontrat medium | gadolinium
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| The portion ofthe brain within the posterior fossa; it includes the pons, medulla oblongata and cerebrum | hindbrain
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| A branch of radiology hat uses catheters to perform therapeutic procedures | interventional radiology
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| An injection into the subarachnoid space of the spinal canal | intrathecal injection
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| An interventional radiology procedure used to treat vertebral body compression fractures using a specialized balloon and bone cement | kyphoplasty
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| An oval shaped area of the brain anterior to the medulla oblongata | pons
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| Sectional images of the body produced with either CT or MRI | slices
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| An extension of the medulla oblongata that runs hrough the spinal canal to the upper lumbar vertebrae | spinal cord
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| An interventional radiology procedure used to treat vertebral body compression fractures by stabilizing bone fragments with cement | vertebroplasty
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